As campuses closed abruptly to limit the spread of COVID-19, college students’ mental health care “was interrupted at a time when they needed support more than ever,” Yujuan Choy, M.D., chief psychiatrist at the University of California, Irvine’s counseling center, writes in Psychiatric Times. Ninety-two percent of the 172 college presidents who responded to a recent Inside Higher Ed and Hanover Research survey reinforced this sentiment, saying they are “very” or “somewhat” concerned about students’ mental health during the pandemic. Without the luxury of time and planning, many colleges have quickly worked to implement telehealth services and address barriers to care.
Digital health services see boom in college contracts
Use of online therapy services has increased massively as colleges and universities shift gears, Education Dive reports. One such service, TAO Connect, offers video conferencing-based therapy appointments and supplemental, self-paced learning modules. Another, Talkspace, allows patients to send text, audio, and video messages to therapists.
Before the pandemic, less than 12 percent of college counseling centers offered telephone counseling, and less than 4 percent offered video counseling, according to a 2018 survey of 571 counseling center directors by the Association for University and College Counseling Center Directors. Now, Mark Hirschhorn, president of Talkspace, says that the needs arising from COVID-19 campus closures have “accelerated the awareness of digital health (services) by probably seven to 10 years,” adding that he believes “we’re at the point of no return,” past which “colleges and universities have to acknowledge that they need to provide these services to their students and faculty.”
Colleges seek remedies for legal restrictions
However, the rapid transition to teletherapy has highlighted several regulatory hurdles for college counseling centers seeking to maintain connections with their students. Institutions, for instance, must assess whether their university malpractice insurance covers telehealth services.
In many states, telemedicine laws limit the number of hours therapists can work with clients living out of state—a barrier for college students who had been seeking therapy but were forced to relocate to another state after campuses closed. State medical boards in Colorado, North Carolina, Delaware, and New Jersey are suspending such restrictions. In addition, 44 states had waived telehealth licensure requirements as of April 15. The federal government is also temporarily permitting health care providers to use video platforms such as Apple Facetime and Google Hangouts for virtual services during the coronavirus pandemic.
Without universal or standardized guidance, mental health care providers are having trouble deciphering exceptions to regulations as they apply to routine psychiatric care of college students, Choy writes. She proposes creating “a special telepsychiatry license allowing campus psychiatrists to work with students enrolled in their universities, regardless of where the students are located,” to simplify systems, reduce costs to students, and shorten wait times.
In the meantime, some colleges restricted from providing services for their out-of-state students are helping to connect students with other university counseling centers or mental health care providers in areas where students reside. Other institutions are launching online support groups, which are not subject to state licensure laws. The counseling center at North Carolina-based Davidson College created a group for anxiety management. Nyack College in New York City hosted a webinar on coping with anxiety and plans to start two more support groups after the webinar’s success.
The University of South Carolina is training more counselors to provide teletherapy. David Graham, director of Davidson’s Center for Student Health and Well-Being, was a skeptic before receiving similar training. “I’m seeing some students really tune in, and it’s fascinating that for some students, I actually think they’re getting more virtually than they are sitting in a room with me.”
Flexibility crucial for some students
Given that some students are contending with unreliable internet access, unsupportive families, and lack of privacy, flexibility also is key to delivering mental health care right now. Shivani Nishar, a senior cognitive science major at Brown University, says that colleges should provide unscheduled counseling opportunities. “Say someone’s parent runs an errand and is finally out of the house, and the student is finally safe to jump on a call,” she posed. “Can that student call in and be immediately redirected to someone?”
Diana Cusumano, director of campus and wellness initiatives at the Jed Foundation, which works to protect emotional health and prevent suicide among teenagers and young adults, proposed that colleges offer mobile-based services that students can use while walking around their neighborhood or sitting in their car. She suggested that asynchronous therapy conducted through texting and email can help.
Learn more about the well-being resources and virtual meetings available to connect Georgetown University students, faculty, and staff with mental health and telehealth professionals.